The role of thinking

The way you think about yourself, your situation, and your future is extremely important in chronic pain, for a number of reasons.

Thoughts are one of the most powerful influences on your mood and emotions, if not the most powerful influence. This doesn't mean that situations themselves are not good or bad or easy or hard. But how you think about difficult situations determines how you respond emotionally. Some thought inflame and exacerbate your distress, anger, depression, fear, anxiety and worry, and others help you to reduce your distress, so that things seem more manageable.The more you can reduce your own distress with your thinking, the more you reduce your adrenaline levels , which is good for nervous system desensitisation.The more you can generate helpful thinking patterns that improve your mood, the more helpful neurotransmitters you are likely to produce, such as opiates. These are your body's natural feel good chemicals. When your body produces feel-good chemical, they help to reduce the level of signal in your pain pathways.Unhelpful thought can interfere with your ability to pace your activities and work towards goals . Many people in chronic pain get into the habit of constantly heckling themselves, which makes it very difficult to persist with potentially useful strategies. Demoralising thoughts like "there's no point doing this, I'll never get better" make you unlikely to put pacing into practice, which stops you ever finding out if it works.

Automatic Thoughts

Automatic thoughts are an internal monologue that runs alongside our daily life, usually outside of our awareness. It is like a little tape playing at the back of our mind, giving us a commentary on ourselves and the world. It passes judgement on ourselves and others, tells us what to expect, what to be afraid of, what to believe, what to trust and what not to trust, and helps us make meaningful sense of ourselves, our environment, and our future. We are so used to this running commentary that we rarely even notice it. What we notice is the feelings that the commentary creates. For instance, we may be unaware of our automatic anticipation of failure or success in a given situation, but we are aware of whether we feel anxious or calm.

Automatic thoughts can be helpful or unhelpful. They can be realistic or unrealistic. The first step in generating helpful thinking patterns is to tune in to your automatic self talk. Try consciously noting down what you think and see what you are saying to yourself. Then relate these thoughts with how they affect the way you feel. What effect does that have on your pain?